Diabetes

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy.

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What is Diabetes?

Diabetes is a disease of the pancreas, an organ located behind your stomach. Normally, the pancreas releases a substance called insulin into the blood. Insulin helps the body to use sugars and fats that are broken down from the foods we eat. When a person has diabetes, the pancreas:

  • Does not make insulin
  • Makes only a little insulin or,
  • Makes insulin, but the insulin does not work as it should.

Diabetes is a lifelong disease. People with diabetes must manage their disease to stay healthy.

Diabetes is classed as a metabolism disorder.

Diabetes (diabetes mellitus) is classed as a metabolism disorder. Metabolism refers to the way our bodies use digested food for energy and growth. Most of what we eat is broken down into glucose. Glucose is a form of sugar in the blood - it is the principal source of fuel for our bodies.

When our food is digested, the glucose makes its way into our bloodstream. Our cells use the glucose for energy and growth. However, glucose cannot enter our cells without insulin being present - insulin makes it possible for our cells to take in the glucose.

Insulin is a hormone that is produced by the pancreas. After eating, the pancreas automatically releases an adequate quantity of insulin to move the glucose present in our blood into the cells, as soon as glucose enters the cells blood-glucose levels drop.

A person with diabetes has a condition in which the quantity of glucose in the blood is too elevated (hyperglycemia). This is because the body either does not produce enough insulin, produces no insulin, or has cells that do not respond properly to the insulin the pancreas produces. This results in too much glucose building up in the blood. This excess blood glucose eventually passes out of the body in urine. So, even though the blood has plenty of glucose, the cells are not getting it for their essential energy and growth requirements.

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Type 1 Diabetes

Type 1 diabetes occurs when the immune system mistakenly attacks and kills the beta cells of the pancreas. No, or very little, insulin is released into the body. As a result, sugar builds up in the blood instead of being used as energy. About five to 10 per cent of people with diabetes have type 1 diabetes. Type 1 diabetes generally develops in childhood or adolescence, but can develop in adulthood.

Type 1 diabetes is always treated with insulin. Meal planning also helps with keeping blood sugar at the right levels.

Type 1 diabetes also includes latent autoimmune diabetes in adults (LADA), the term used to describe the small number of people with apparent type 2 diabetes who appear to have immune-mediated loss of pancreatic beta cells.

Type 2 Diabetes

Type 2 diabetes occurs when the body can’t properly use the insulin that is released (called insulin insensitivity) or does not make enough insulin. As a result, sugar builds up in the blood instead of being used as energy. About 90 per cent of people with diabetes have type 2 diabetes. Type 2 diabetes more often develops in adults, but children can be affected.

Depending on the severity of type 2 diabetes, it may be managed through physical activity and meal planning, or may also require medications and/or insulin to control blood sugar more effectively.

Gestational Diabetes

A third type of diabetes, gestational diabetes, is a temporary condition that occurs during pregnancy. It affects approximately two to four per cent of all pregnancies (in the non-Aboriginal population) and involves an increased risk of developing diabetes for both mother and child.


Questions When a Loved One Has Diabetes

What causes diabetes? +

Health care providers do not yet know what causes diabetes. The following factors may increase your chance of getting diabetes:

  • Family history of diabetes
  • African-American, Hispanic, Native American or Asian-American race or ethnic background
  • Being overweight
  • Age (Chances increase with age)
  • Taking certain medicines
  • Being pregnant*

*Pregnancy puts extra stress on a woman's body that causes some women to develop diabetes. Blood sugar levels often return to normal after childbirth. Yet, women who get diabetes during pregnancy have an increased chance of developing diabetes later in life.

What are the types of diabetes? +

There are two types of diabetes: type 1 and type 2.

  • Type 1 diabetes — The pancreas makes little or no insulin. A person with type 1 diabetes must take insulin to survive. This type occurs most often in people who are under 30 years old.
  • Type 2 diabetes — Insulin is made but it doesn't work as it should. Nine out of 10 people with diabetes have type 2 diabetes. This type occurs most often in people who are over 40 years old and overweight.

How is diabetes managed? +

Diabetes is managed through proper diet, exercise and, if needed, medication. People with diabetes must use home and office tests to monitor the levels of sugar, cholesterol, and triglycerides (a type of fat) in their blood. Steps are then taken to keep the levels of these substances as normal as possible.

Type 1 diabetes is controlled with:

  • Insulin shots
  • Meal planning
  • Exercise

Type 2 diabetes is controlled with:

  • Diet and exercise
  • Medicine taken by the mouth
  • Insulin shots (less common)

What are the symptoms of diabetes? +

Type 1 diabetes

The symptoms of type 1 diabetes are often severe and sudden. These symptoms include:

  • Increased thirst
  • Dry mouth
  • A need to urinate often
  • Weight loss (even though you are eating and feel hungry)
  • Weak, tired feeling
  • Blurred vision

Type 2 diabetes

The symptoms of type 2 diabetes often go unnoticed. These symptoms build up over time and include:

  • Blurred vision
  • Slow healing sores or cuts
  • Itchy skin (usually in the vaginal or groin area)
  • Yeast infections
  • Increased thirst
  • Dry mouth
  • A need to urinate often

How can I know if I have diabetes? +

Your health care provider can perform blood and urine tests to see if you have diabetes. Normal blood sugar is between 70 mg/dl and 100 mg/dl. The standard diagnosis of diabetes is made when two blood tests show that your fasting blood sugar level (blood sugar before you have eaten anything) is 126 mg/dl or greater.

Can diabetes be cured? +

No. A cure for diabetes has not yet been found. However, diabetes can be treated and controlled. Most people with diabetes manage their disease and lead normal lives. Without proper care, diabetes can lead to:

  • Heart disease
  • Kidney disease
  • High blood pressure
  • Low blood pressure
  • Eye damage and blindness
  • Gum disease
  • Serious infections in feet, sometimes requiring amputation
  • Damage to nerves, resulting in pain or loss of sensation

What should my blood sugar level be? +
What are the symptoms of low blood sugar? +

Most people have symptoms of low blood sugar (hypoglycemia) when their blood sugar is less than 60 mg/dl. (Your health care provider will tell you how to test your blood sugar level.)

When your blood sugar is low, your body gives out signs that you need food. Different people have different symptoms. You will learn to know your symptoms.

Common low blood sugar symptoms include the following:

Early symptoms

You may:

  • Feel weak
  • Feel dizzy
  • Feel hungry
  • Tremble
  • Feel shaky
  • Sweat
  • Have a pounding heart
  • Have pale skin
  • Feel frightened or anxious

Late symptoms

You may:

  • Feel confused
  • Have a headache
  • Feel cranky
  • Have poor coordination
  • Have bad dreams or nightmares
  • Be unable keep your mind on one subject
  • Feel a numbness in your mouth and tongue
  • Pass out

Can I take both pills and insulin to control my blood sugar? +

Yes. The combination of insulin and an oral medication, when taken as directed by your doctor, is very safe and effective in controlling blood sugar. A typical combination therapy consists of taking an oral medication during the day and insulin at night. Once you begin taking insulin, you will need to monitor your blood sugar more often to reduce the risk of low blood sugar reactions.

Combination therapies are often helpful for people who have type 2 diabetes (adult onset diabetes). If you have been taking an oral medication, your doctor may change your treatment plan to include insulin injections. This change is often made to help people with type 2 diabetes gain better control of their blood sugar.

What are insulin pumps? +

Insulin pumps are small, computerized devices, about the size of a beeper, that you wear on your belt or put in your pocket. They have a small flexible tube with a fine needle on the end. The needle is inserted under the skin of your abdomen and taped in place. A carefully measured, steady flow of insulin is released into the tissue. Insulin pumps can cost $6,000 to $10,000 for the pump. There are additional costs for necessary supplies to use the pump.

Using a pump requires you to monitor your blood sugar level at least four times a day. You program doses and make adjustments to your insulin, depending on your food intake and exercise program. Some health care providers prefer the insulin pump over injections because its slow release of insulin mimics a working pancreas.

How can I monitor the development and progression of diabetic complications? +

Eye disease (retinopathy)

All patients with diabetes should see an ophthalmologist yearly for a dilated eye examination -- beginning at diagnosis in people with type 2 diabetes, and after 5 years in people with type 1 diabetes after puberty. Patients with known eye disease, symptoms of blurred vision in one eye, or blind spots may need to see their ophthalmologist more frequently.

Kidney disease (nephropathy)

Urine testing should be performed yearly. Regular blood pressure checks are important, since control of hypertension (high blood pressure) is essential in slowing kidney disease. Generally, blood pressure should be maintained less than 130/80 in adults. Persistent leg or foot swelling may be a symptom of kidney disease and should be reported to your doctor.

Nerve disease (neuropathy)

Numbness or tingling in your feet should be reported to your doctor at your regular visits. You should check your feet daily for redness, calluses, cracks, or skin breakdown. If you notice these symptoms before your scheduled visit, notify your doctor immediately.

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